Only 6.9% of people with mental health or substance use disorders receive effective treatment, largely due to lack of recognition and inadequate care. A global study highlights the need for better-trained general practitioners and policy-driven mental health investments.
A new study estimates that globally, only 6.9% of individuals with mental health or substance use disorders receive effective treatment.
Researchers from the University of British Columbia and Harvard Medical School analyzed survey data from nearly 57,000 participants across 21 countries over a 19-year period. Their findings provide the most comprehensive insight yet into where people disengage from the path to effective treatment for nine common anxiety, mood, and substance use disorders.
The study identified the greatest barrier to treatment as a lack of recognition that help is needed. However, even among those who seek medical care, many do not receive effective treatment.
Lack of Data-Driven Policy in Mental Health
“This survey data has allowed us to create the only effective treatment indicator that exists for mental health and substance use,” said lead author Dr. Daniel Vigo, associate professor at UBC’s department of psychiatry and school of population and public health. “Policy decisions and allocative decisions for funding should be guided by data, and this hasn’t always been the case in the realm of mental health and substance use.”
The World Health Organization-World Mental Health Surveys Initiative collects data on the prevalence, severity, and treatment of mental disorders worldwide. This study focused on survey participants who met the criteria for a disorder under the Diagnostic and Statistical Manual of Mental Disorders-IV, a standardized classification system used by mental health professionals from 1994 to 2013.
Where Patients Drop Off in the Treatment Process
The team, led by Dr. Vigo and Dr. Ronald Kessler of Harvard, was interested in how close participants got to receiving effective treatment that met evidence-based guidelines—and where they might have dropped off along the way.
They analyzed four key steps, and the percentage of people who proceeded from each step to the next:
- Recognize their need for treatment
- Make contact with the healthcare system about it
- Receives a minimum level of adequate treatment
- Receives effective treatment
They found:
- Only 46.5 percent of people who met the criteria for a disorder recognized their need for treatment.
- Of those who did recognize their need, only 34.1 percent turned to the medical system for help.
- Most who sought help (82.9 percent) received a minimum level of adequate treatment.
- About 47 percent of people who received minimally adequate treatment ended up receiving effective treatment.
Attrition at various points along this pathway meant that only 6.9 percent ended up receiving effective treatment.
Bottlenecks in the Healthcare System
“Understanding where the bottlenecks are for each of these disorders provides a unique and previously unavailable blueprint for decision makers to understand problems objectively and try to adjust the system,” said Dr. Vigo.
The study revealed a significant drop-off after patients contacted the healthcare system but before they received effective treatment. Since general practitioners and family doctors are typically their first point of contact with the system, it’s essential to make sure those doctors have appropriate training, said Dr. Vigo.
“Improving the ability of these general practitioners and family doctors to diagnose and treat the mild to moderate forms, and to know when to refer more severely affected folks to specialists, becomes the cornerstone of the system,” he said.
The research provides decision-makers with a base of evidence to guide policy and funding decisions in mental health and substance use. By highlighting gaps in service needs and outcomes for disorders ranging from bipolar disorders to addiction, it identifies where targeted investments could potentially yield the greatest impact. Armed with these insights, policymakers worldwide can prioritize interventions that result in improvements in care.
Reference: “Effective Treatment for Mental and Substance Use Disorders in 21 Countries” by Daniel V. Vigo, Dan J. Stein, Meredith G. Harris, Alan E. Kazdin, Maria Carmen Viana, Richard Munthali, Lonna Munro, Irving Hwang, Timothy L. Kessler, Sophie M. Manoukian, Nancy A. Sampson, Ronald C. Kessler, World Mental Health Survey Collaborators, Sergio Aguilar-Gaxiola, Jordi Alonso, Laura Helena Andrade, Corina Benjet, Guilherme Borges, Ronny Bruffaerts, Brendan Bunting, José Miguel Caldas-de-Almeida, Graça Cardoso, Alfredo H. Cía, Giovanni de Girolamo, Ymkje Anna de Vries, Oye Gureje, Josep Maria Haro, Hristo Hinkov, Aimee Nasser Karam, Elie G. Karam, Georges Karam, Norito Kawakami, Andrzej Kiejna, Viviane Kovess-Masfety, Maria Elena Medina-Mora, Jacek Moskalewicz, Fernando Navarro-Mateu, Daisuke Nishi, Marina Piazza, José Posada-Villa, Annelieke Roest, Juan Carlos Stagnaro, Margreet ten Have, Yolanda Torres, Maria Carmen Viana, Cristian Vladescu, David R. Williams, Bogdan Wojtyniak and Miguel Xavier, 5 February 2025, JAMA Psychiatry.
DOI: 10.1001/jamapsychiatry.2024.4378
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8 Comments
Hideous propaganda!!! “Treatment” and “Impact” involves misdiagnosis and neurotoxic poisoning! No antidote for the permanent brain damage “treatment” of healthy human beings does! This happened to me! 48 years of a wonderful life destroyed! It’s all about $$$ and inflicting harm! The industry is pure corruption!
So what would you suggest as an alternative?
I’d suggest that doctors try looking for physical causes before prescribing psychotropic medications. I’d also suggest starting with the basics, vitamin deficiencies. If not vitamin deficiencies, then I’d check for food allergies or allergies of any sort, for that matter. Our medical system must start treating the body as a whole, not just it’s parts.
Agree this. I got a prison sentence with mental health and my my attacker free. I was misdiagnosed . I had PTSD. I was given these highly addictive meds and told safe. Im at the final stretch reducing my meds.
They rarely validate you.
Your a project not a human being.
Alternative , remove stigma from within mental health
It biased and full of discrimination .
Treatment such as emdr and brainspotting work if the clinicians actually use them. Talk therapy is a pipeline to drugs, both of which are a scam.
The “shocking” part of this is how “shocking” this “news” from the “Department of the Obvious” was for some people.
Study says the lack of effectiveness is “largely due to lack of recognition and inadequate care” and that “Policy decisions and allocative decisions for funding should be guided by data, and this hasn’t always been the case in the realm of mental health and substance use.”
Well…. obviously. Those of us with an actual, vested interest in the subject of effective treatment, including that for substance abuse and mental illness, have been shouting this from the rooftops for a long time. What took YOU so long to figure it out?
The findings:
•Only 46.5 percent of people who met the criteria for a disorder recognized their need for treatment.
•Of those who did recognize their need, only 34.1 percent turned to the medical system for help.
•Most who sought help (82.9 percent) received a minimum level of adequate treatment.
•About 47 percent of people who received minimally adequate treatment ended up receiving effective treatment.
•Attrition at various points along this pathway meant that only 6.9 percent ended up receiving effective treatment.
The questions to now answer, oh educated “experts”, are:
1- “WHY did the other 65.9 percent NOT try to seek the “help” of the “medical system”?
2. “WHY did only 17.1 percent receive more than just a minimal level of adequate treatment”?
3. “WHY did 93.1 percent of people seeking treatment get Ineffective treatment when y’all in the research field have (presumably) also been those on the front lines DEVISING that treatment AND assisting in the drafting of policy and practices?
And lastly, the 64,000 question for those in the field providing all that innafective care, why are more than half your patients (you met with them at least once, else you could not know that they “meet the criteria” unable to recognize their need for care after you have met with them, if you are as good at what you do as you say….oh, wait….
Perhaps you might revisit finding 2, in light of question 3?
Guess the “experts” have finally pulled their self-serving, ignorant, disinterested, and/or woefully biased collective head out of their collective butt long enough to hear and decide the above questions were worth checking into in order to validate or disprove.
You’ve been running a bit late, folks, but welcome aboard this accountability train nonetheless. You gonna help us with the heavy lift, now, or will you insist on being foreman just cus you happen to have pricey, fancy letters next to your name?
🙄🙄🙄🙄🙄
#substanceabuseawareness #mentalhealthawareness #recovery #MentalHealth
It biased and full of discrimination .